Eur Heart J

NSAIDs double bleeding risk in VTE patients on anticoagulants

November 26, 2024

Study Design: This nationwide cohort study analyzed data from 51,794 patients in Denmark who initiated oral anticoagulant therapy for VTE between 2012 and 2022. Researchers employed time-dependent multivariable Cox regression to assess the relationship between NSAID use and hospital-diagnosed bleeding events.

Results: Incidence of any bleeding was 3.5 per 100 person-years without NSAID use, compared with 6.3 per 100 person-years during NSAID use, yielding a number needed to harm of 36 for one year of treatment. The adjusted hazard ratios for bleeding associated with NSAID use were 2.09 overall, with specific risks of 1.79 for ibuprofen, 3.30 for diclofenac, and 4.10 for naproxen. Notably, NSAID use increased risks for GI and intracranial bleeding.

Impact on Clinical Practice: These findings emphasize the need for caution when prescribing NSAIDs to patients on anticoagulants. Clinicians should consider alternative analgesics and implement strategies to minimize concurrent NSAID use to reduce bleeding complications.

Source:

Petersen SR, et al. (2024, November 18). Eur Heart J. Bleeding risk using non-steroidal anti-inflammatory drugs with anticoagulants after venous thromboembolism: a nationwide Danish study. https://pubmed.ncbi.nlm.nih.gov/39551938/